Suicide Prevention: Risk Factors and Warning Signs
September 6, 2022
According to the American Foundation for Suicide Prevention, in 2020, suicide was the 12th leading cause of death with an average of 130 suicides per day in the US (AFSP, 2020). Understanding risk factors that increase the chances of suicide attempts and suicide deaths are a necessary part of suicide prevention. It’s common knowledge that suicide is a mental health and public health issue, but suicide is also a social justice issue. With stigma about suicide, systemic problems such as lack of access, lack of adequate care including effective therapeutic interventions such as crisis interventions and grief support, people experiencing suicidal thoughts are marginalized, which increases their isolation (NAMI, 2017).
It’s time for systemic change in suicide response and prevention in our health care systems and communities. One way of promoting community wide awareness and advocacy may include community events such as suicide prevention walks. Mental healthcare providers can be a part of the positive change by staying up to date on the latest suicide statistics and research, including evidence based treatment interventions and resources for crisis and grief support (NAMI, 2017). Educating ourselves about suicide research and the misconceptions about suicide is another way to promote systemic change in communities. Misconceptions can compound the marginalization and stigmatization of people experiencing suicidal thoughts. To learn more about myth busters and facts about suicide please visit: https://suicideprevention.nv.gov/Youth/Myths/.
Factors that Increase Risk of Suicide
Psychosocial Stressors and Major Life Changes:
Recent stressful events including: a break up, loss of a relationship, separation or divorce, losing a job, death or terminal illness of a loved one, grief, a traumatic event, and legal issues can increase the risk of suicide.
Certain times including holidays, anniversaries, recent discharge from a hospital, receiving a diagnosis of a medical condition or mental health disorder, and starting antidepressant medication treatment are other times where suicide risk may be higher.
Major life changes, even positive ones, including getting a new job, moving, or welcoming a baby are times of adjustment and stress which can lead to individuals feeling overwhelmed, which increases risk of mental health issues.
Emotional and Behavioral Changes:
A person experiencing suicidal thoughts may feel overwhelmed, like a burden to others, and may experience emotional pain, self-loathing, excessive guilt, and shame (Raypole, 2022).
Important behavioral changes that may indicate the presence of depression and/or suicidal ideation: an individual seems depressed, sad, or withdrawn. You notice the person is isolating and doesn’t seem interested in their usual activities such as work, relationships, or interests/hobbies. The person may not be interested in sex or hanging out with friends or family like they usually do. The person may be more irritable, get angry more easily, and may experience changes in their sleeping and eating habits.
Other Risk Factors:
Other risk factors commonly associated with suicide include drug and/or alcohol misuse, impulsivity and poor impulse control, learning of someone who recently died by suicide, having access to firearms or other lethal means, chronic illness/pain, previous suicide attempts, and people with comorbid psychiatric conditions such as depression and bipolar disorder, and access to firearms or other lethal means.
Warning Signs of Suicidal Thoughts:
- Appears depressed and/or withdrawn
- They’ve had previous suicide attempts
- They talk about death
- They make hopeless statements such as “I wish I were dead” or “I can’t keep living like this”
- Statements about feeling like a burden to others such as “You’d be better off without me”
- Talking openly about wanting to kill themselves or making statements or self-deprecating jokes about killing themselves
- They begin to develop a plan for suicide, including acquiring the means to carry it out, rehearsing the plan, or setting a time for the attempt
- Going from being depressed to being happy or calm for no apparent reason can be a sign that the person has made the decision to carry out their plan and may have a sense of relief that their emotional pain will be over soon (Raypole, 2022).
Groups at Higher Risk:
Middle aged white men are at increased risk to die by suicide, but there are other demographic groups who are also at increased risk vs. the general population. These groups include:
Individuals 85 years and older, especially elderly men
- Women and gender diverse people
- Children, teenagers, and young adults
- Suicide attempt survivors are at an increased risk of attempting again and dying by suicide.
- Suicide loss survivors (AFSP, 2020)
If you are concerned about someone you know such as a family member, friend, or coworker who appears depressed and displaying warning signs of suicidal thoughts, tell them you’re concerned about them and encourage them to seek professional help such as talking to their doctor, starting therapy, and/or starting medication treatment. Be persistent and supportive.
If the person is in imminent danger of hurting themselves, stay with them, remove anything they could harm themselves with, and take them to the nearest emergency department as soon as you can. It’s important to take any person seriously when they disclose suicidal thoughts. Passive suicidal thoughts/ideation (e.g. having thoughts of being better off dead) can quickly turn to active thoughts (e.g. thinking about how they’d kill themselves, making a plan, etc.) depending on life situations/stressors, worsening depression and hopelessness, and other background risk factors the individual may have.
Both passive and active suicidal ideation warrant a thorough risk assessment and safety plan by a professional. If you or someone you know are experiencing any thoughts of death or suicide, please call or text The National Suicide Prevention Lifeline at 988. For more resources, click the link Healthline Resource Guide.
Makenzie Pacubas, MSW, LCSW
CHE Quality Assurance Associate
Makenzie is a clinical social worker who has worked in the mental health field for over a decade and now works in clinical quality assurance with CHE Behavioral Health Services. Makenzie lives in Kansas City, Missouri with her partner, Justin, and their three pets. Makenzie likes art, singing, exercising, reading, getting outdoors, and trying new restaurants.
American Foundation for Suicide Prevention. “Suicide Statistics.” American Foundation for Suicide Prevention, American Foundation for Suicide Prevention, 2019, afsp.org/suicide-statistics/.
Raypole, Crystal. “What You Should Know about Suicide.” Healthline, 14 June 2012, www.healthline.com/health/suicide-and-suicidal-behavior#hotlines-and-resources. Accessed 9 Aug. 2022.
“Suicide Prevention as a Social Justice Issue | NAMI: National Alliance on Mental Illness.” Nami.org, 2017, www.nami.org/Blogs/NAMI-Blog/September-2017/Suicide-Prevention-as-a-Social-Justice-Issue.